Genesis I Assisted Living Facility Inc.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

GENESIS I ASSISTED LIVING FACILITY INC.

Practice address

324 Mine Rd
Midway, FL 32343-2710

Phone

(850) 510-1757

NPI assigned

Jul 19, 2021

Last updated

Jul 19, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy Franklin

Title

Vice President

Phone

(850) 510-1757

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Myshia Duncan Reid, BS

  • Case Manager/Care Coordinator
  • Brooklyn, NY
  • NPI 1982007472
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1255904231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 MINE RD",
            "city": "MIDWAY",
            "state": "FL",
            "postal_code": "323432710",
            "telephone_number": "850-510-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 MINE RD",
            "city": "MIDWAY",
            "state": "FL",
            "postal_code": "323432710",
            "telephone_number": "850-510-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS I ASSISTED LIVING FACILITY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "FRANKLIN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "850-510-1757"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denorice Lashay Dillard, COTA/L
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• Wanda Franklin
• Roncaglia Gibson
• Global Mobility Non Emergency Medical Transportation, LLC
• Danyell Imari Gray
• Helping Hands Homemaker & Companion Services LLC.
• Helping Hands of North Florida Inc.

• Assisted Living Facility (Mental Illness) in Midway, FL
• Providers in Midway, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.